23
Manuscripts
Released in 1979 through 2023
4
Manuscripts
Impact studies rated high or moderate quality
Skip to: Effectiveness Implementation
Where to find out more
Kentucky Department for Public Health
Division of Maternal and Child Health
275 E. Main Street, Mailstop HS2-EE, Frankfort, KY 40621
This model meets criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.
Does not meet criteria for an evidence-based home visiting model for Indigenous peoples and communities.
For more information about manuscripts, search the research database.
For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.
23
Manuscripts
Released in 1979 through 2023
11
Manuscripts
Eligible for review
4
Manuscripts
Impact studies rated high or moderate quality
To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.
Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.
No effect:
Findings are not statistically significant.
Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.
| Outcomes | Manuscripts | Favorable Findings | No Effects Findings | Unfavorable Findings |
|---|---|---|---|---|
| Child development and school readiness | Not measured | - | - | - |
| Child health | View 4 Manuscripts | 6 | 3 | 0 |
| Family economic self-sufficiency | View 3 Manuscripts | 2 | 0 | 1 |
| Linkages and referrals | Not measured | - | - | - |
| Maternal health | View 3 Manuscripts | 7 | 1 | 0 |
| Positive parenting practices | Not measured | - | - | - |
| Reductions in child maltreatment | View 1 Manuscript | 1 | 0 | 0 |
| Reductions in juvenile delinquency, family violence, and crime | Not measured | - | - | - |
Well-designed impact studies about this model included participants with the following characteristics:
Race/Ethnicity
Maternal Education
Well-designed impact studies about this model were conducted in the following locations:
In this section:
Support Availability
Service Delivery
Model services, adaptions and enhancements, model intensity and length.
The Health Access Nurturing Development Services (HANDS) program aims to support families as they build healthy and safe environments for children’s optimal growth and development. The program is based on several key assumptions:
HANDS serves new and expectant parents who enroll during pregnancy or any time before a child is 90 days old. Eligible families face multiple challenges and stressors related to their parenting experiences and expectations, child and family health, social environment, family life, and basic needs.
HANDS is designed to improve pregnancy and birth outcomes; enhance children’s growth and development; create healthy, safe homes; and promote self-sufficient families.
Highlights
The HANDS program is a voluntary statewide home visitation program authorized by the Kentucky Legislature in 2000. The Department for Public Health administers the program through local health departments and contracted sites in every county. Within the Department of Public Health is a state office team consisting of:
In addition, trainers provide guidance to HANDS staff throughout the state.
The state office regional teams consist of QAs and TAs who have experience in the HANDS program and have completed the HANDS QA training or TA training, respectively. Both QAs and TAs work with other HANDS team members to identify and address concerns, promote program growth, and evaluate outcomes. QAs assess site productivity and implementation through annual quality assurance site visits to each HANDS site. Sites receive written documentation about their overall performance and areas for growth. TAs support the implementation of the model, with the goal of consistent implementation at local HANDS sites throughout the state. TAs help sites prioritize needs based on areas for growth identified during the QA site visit.
Highlights
HANDS home visitors initiate an assessment process to determine a family’s eligibility and identify their strengths and needs. This process may start during pregnancy or any time before the child is 90 days old. To assess eligibility, the home visitor discusses the following topics with the family: (1) prenatal care and prior pregnancies; (2) tobacco, alcohol, or substance misuse; (3) mental health history such as depression, postpartum depression, medications, and counseling; (4) the child’s development; (5) access to supports such as family and social networks; (6) marital or family stressors, including violence and childhood trauma; (7) basic needs such as employment, income, and housing; and (8) current stressors such as parenting expectations and transportation. If the assessment indicates a family may benefit from HANDS services, the family is offered home visiting services through HANDS. If a family is ineligible for services, the home visitor shares information about community resources.
For families engaged in home visits, trained home visitors provide services using the Growing Great Kids® curriculum. They also conduct developmental and social-emotional screenings for children and screenings for domestic violence and perinatal depression in parents. Services focus on strengthening families by building parenting skills, fostering secure parent-child attachment, and facilitating family goal setting. Home visitors also provide targeted support through resource referrals with the aim of strengthening the family’s resilience by building the family’s social connections within their community and offering concrete assistance. Health promotion is also a key focus of HANDS home visitation, and home visitors encourage families to establish medical homes, maintain health insurance coverage, and engage in preventative services such as well-child visits.
The home visitor, supervisor, and family determine the intensity of services based on a family’s progression through the HANDS program and their assessed need. Families progress as they successfully meet criteria outlined in the HANDS “level” system, which ranges from a high intensity (weekly visits) to a low intensity level (quarterly visits). All families are not expected to move through all levels. Regardless of level, home visits last about an hour. Level intensity determines whether families are eligible to participate until the child’s second or third birthday. Please contact the model developer for additional information about the length of the HANDS program.
Please contact the model developer for information about adaptations or enhancements to the model and the process for considering modifications to the model.
Highlights
Local agencies must employ home visitors and supervisors. Programs may have additional staff roles to support intake, data entry, or other program functions.
Kentucky regulations state that both professionals and paraprofessionals may serve as home visitors. The supervisor must be a licensed nurse or social worker.
Supervision is required for all employees. Supervisors oversee day-to-day program operations to ensure adherence to HANDS policies and procedures. Supervisors support and promote quality home visitation services, healthy supervisor-to-staff-to-family relationships, and staff development. They also work to reduce staff burnout and improve staff retention. Please contact the model developer for information on the mode and frequency of supervision and to learn about support that is offered to supervisors.
Before providing services, home visitors must complete core training on the HANDS model and curriculum, along with trainings on preventing and recognizing child abuse with a specific focus on pediatric abusive head trauma. Additional mandatory training topics are required at set intervals. Supervisors must complete all required home visitor trainings in addition to specialized training on supervision. Please contact the model developer for additional information about the pre-service training and ongoing professional development requirements.
HANDS is implemented by Kentucky’s Department for Public Health through local public health agencies or a local health or human service agency that serves as a subcontractor to local public health agencies.
HANDS programs must adhere to the model’s guiding principles. Please contact the model developer for additional information about the guidelines.
Highlights
HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer as of the above date. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.